Clinical aspects and treatment of midface fractures through inter-personal violence: a 10 year cross-sectional cohort retrospective study

The incidence of midface fractures due to inter-human aggression (IPV) has increased dramatically in industrialized countries recently. In this context, the World Health Organization considers the treatment and counseling of IPV victims an international priority.  The aim of this study was to determine the characteristics of midface fractures by IPV in order to create the premises for a correct and rapid diagnosis by the clinician, as well as to evaluate the effectiveness of treatment methods applied depending on the number and type of postoperative complications. Materials and methods: Patients hospitalized and treated in a tertiary hospital for oral and maxillofacial surgery for a period of 10 years were available for this study. After the statistical analysis of the variables followed, a value of p <0.005 was considered statistically significant. Results: The most common was zygomatic complex fracture n = 87 (51.80 %), followed by fracture of nasal bones n = 30 (17.90%), orbit n = 36 (21.40 %) . Most patients had fractures with displacement n = 124 (73.80%) and closed n = 150 (89.3%). The opening of the fracture was most common in the case of zygomatic complex fractures (p = 0.045). The most common soft tissue lesion was present in 134 patients (57.26%), followed by excoriation n = 58 (24.79%) and laceration n = 42 (17.95%). Most patients were treated with closed treatment methods n = 145 (86.32%), followed by combined treatment methods open reduction with internal fixation (ORIF) + maxilla-mandibulo fixation (MMF) n = 12 (7.14% ) and n = 11 (6.55%) strictly ORIF. Conclusions: Inter-human aggression most frequently causes complex-zygomatic fractures, complete, with displacement and without opening the fracture outbreak accompanied by hematomas of the soft parts. The severity of the soft tissue associated injuries is directly proportional to the underlying fracture pattern

A Naso-Orbito-Ethmoid (NOE) Fracture Associated with Bilateral Anterior and Posterior Frontal Sinus Wall Fractures Caused by a Horse Kick—Case Report and Short Literature Review

Naso-orbito-ethmoid (NOE) fractures associated with anterior and posterior frontal sinus wall fractures are among the most challenging cranio-maxillofacial injuries. These represent a major emergency, having a potentially severe clinical picture, with intracranial hemorrhage, cerebrospinal fluid (CSF) leak, meningeal lesions, pneumocephalus, contusion or laceration of the brain matter, coma, and in some cases death. In this article, we present the case of a 30-year-old patient with the diagnosis of NOE fracture associated with bilateral anterior and posterior frontal sinus wall fractures caused by a horse kick, with a fulminant post-traumatic alteration of the neurological status and major impairment of the midface bone architecture. Despite the severity and complexity of the case, early initiation of correct treatment both in terms of intensive care and cranio-maxillofacial surgery led to the successful rehabilitation of the neurological status, as well as to the reconstruction and redimensioning of midface architecture and, not least, to the restoration of the patient’s physiognomy

The Etiology and Epidemiology of Pediatric Facial Fractures in North-Western Romania: A 10-Year Retrospective Study

Pediatric facial fractures are not as common as facial fractures occurring in the adult population. Their therapeutic approach is different because they affect patients with active growth, and have an etiology and epidemiology that vary depending on different cultural, religious and demographic factors. This research aimed to identify the main factors involved in the etiology of pediatric facial fractures, as well as the epidemiology of pediatric facial fractures in a sample of children and adolescents from North-Western Romania. This 10-year retrospective study was performed in a tertiary center for oral and maxillofacial surgery in North-Western Romania. Medical files of patients that were admitted between 1 January 2002 and 31 December 2022 were analyzed. Pediatric patients aged 0 to 18 years were included in this study. The final sample consisted of 142 children and adolescents diagnosed with facial fractures, with this number representing 14.1% of all patients affected by facial fractures. Most frequently, fractures were identified in the 13–18 age group (78.9%, n = 112), which were more often associated with fractures caused by interpersonal violence than caused by road traffic accidents, falls or animal attacks. Boys were more affected (88%, n = 125), and were more frequently associated with fractures caused by interpersonal violence. The most frequently identified etiological factors included interpersonal violence (50%, n = 71), falls (18.3%, n = 26) and road traffic accidents (11.3%, n = 16). In terms of location, the mandible was the most affected facial bone structure (66.2%, n = 94), and patients with mandibular fractures were more frequently associated with fractures caused by interpersonal violence. The incidence of pediatric facial fractures should be lowered because they may interfere with the proper development of the facial skeleton. Establishing measures aimed at preventing interpersonal violence, as well as other causes involved in the etiology of facial fractures is imperative

Patient's perception of recovery following surgical removal of mandibular third molars. A prospective european multi-center study

This study evaluated patient's perception of recovery following surgical removal of mandibular third molars (SRM3s) including analyze of potential risk factors associated with impaired convalescent. Patient related parameters combined with preoperative questionnaires including Modified Dental Anxiety Scale, Oral Health Impact Profile-14, and Decayed, Missing, Filled Teeth index were correlated with questionnaires assessing pain, swelling, trismus, sick leave, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment, impaired sensation of the lip, chin, and tongue, one month following SRM3s. Totally, 412 patients (223 females, 189 males) with mean age of 29.4 years were included. Treatment satisfaction and willingness to undergo similar surgery were reported by 92% and 95%, although 21% reported that the surgery and postoperative period had been worse than expected. Mean days with pain, sick leave, and swelling were 3.6, 2.1, and 3.6, respectively. Preoperative symptoms, dental anxiety level, and prolonged surgical time were associated with increased pain and swelling (P &lt; 0.05). Pell and Gregory classification (I-IIIC) were associated with impaired sensation of the lower lip and chin (P &lt; 0.05). Consequently, results from this study improve the surgeon's ability to predict parameters that predisposed to impaired recovery and neurosensory disturbances following SRM3s.</p